The wandering spleen syndrome is rare and so is not usually considered in the differential diagnosis of abdominal pain.


The "wandering spleen" is a spleen with laxity or absence of the splenic ligaments. The large of support causes the spleen to be excessively mobile and to migrate to areas away from its usual position in the left upper quadrant just below the diaphragm. If it ends up in the pelvis then it is referred to as "pelvic spleen."


Complications include:

(1) chronic abdominal pain

(2) splenic torsion with acute hemorrhagic infarction

(3) gastric outlet obstruction

(4) compression if there is splenomegaly


Differential diagnosis:

(1) accessory spleen


If the spleen is viable then surgical gastropexy or splenopexy may be attempted.


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